Question

This spot radiograph is from a double-contrast esophagram. The image represents:

• A. Esophageal atresia
• B. Esophageal stenosis
• C. Feline esophagus
• D. Tracheoesophageal fistula

Hint:

Transient fine transverse mucosal folds linked to reflux.

Answer 1

The Correct Option is C

Step 1: The image shows numerous fine 1-2 mm transverse radiolucent folds running across the esophagus in a herringbone-like pattern. These thin transverse bands are the hallmark of feline esophagus.

Step 2: Feline esophagus (also called esophageal shiver) refers to transient transverse folds in the mid and lower esophagus seen on a double-contrast barium swallow. They are caused by contraction of the muscularis mucosae, which shortens the esophagus and bunches the mucosa. The folds are transient and appear following reflux, not during swallowing.

Step 3: The distractors do not match. Esophageal atresia and tracheoesophageal fistula are congenital lesions presenting in neonates, not fine transverse folds. Esophageal stenosis is a fixed narrowing. The transient circumferential fine folds make feline esophagus (option c) the answer, and they are strongly associated with gastroesophageal reflux.